Comparison between late onset and childhood asthma.

BACKGROUND

The onset of asthma frequently occurs after the age of 50 yr and the severity and causes of this late onset disease are poorly known.

METHODS

25 chronic asthmatics (65.7 +/- 6.5 yr) whose asthma started after the age of 50 yr were compared with 23 chronic asthmatic children (11.6 +/- 2.8 yr) and 24 COPD patients (61.6 +/- 3.4 yr). Both asthmatic groups had a similar apparent duration of asthma. None of the asthmatics was a smoker. All COPD were smokers. The severity of asthma was defined according to the Aas score. FVC, FEV1, MMEFR, Raw were tested and reversibility of bronchial obstruction was determined on Raw after salbutamol inhalation. Allergy was assessed by skin prick tests, RAST and total serum IgE (PRIST).

RESULTS

Patients with childhood asthma had: 1) a significantly lower clinical severity of asthma; 2) a significantly less severe bronchial obstruction, and 3) a significantly greater reversibility than old age asthmatics. There was no significant difference between pulmonary function tests pre- and post-bronchodilators between COPD and old-age asthmatics. All asthmatic children and 40% of older patients were allergic.

CONCLUSIONS

The occurrence of asthma in old age patients leads to a more severe course of the disease and allergy appears to play a role in many old age patients.